Sinan Zehir1, R Zehir, Sultan Zehir, İ Azboy, N Haykir. 1. Hitit University Research and Training Hospital Orthopedic and Traumatology Clinic, 19100 Merkez, Corum, Turkey, sinanzehir@yahoo.com.
Abstract
AIM: We sought to determine whether intramedullary fixation with proximal femoral nail antirotation produces comparable outcomes to dynamic hip screw in the treatment of unstable trochanteric fractures. MATERIALS AND METHODS: Patients were randomly allocated to receive proximal femoral nail antirotation (Group 1, n = 96, mean age; 77.22 ± 6.82 years) or dynamic hip screw (Group 2, n = 102, mean age; 76.86 ± 6.74 years). Outcome measures were time of operation and fluoroscopy, amount of blood loss and occurrence of surgery-related complications. Tip-apex distance and femoral neck shortening were also evaluated. Patients were evaluated at the sixth month to assess the recovery of walking ability. Survival information was obtained from a civil registry. RESULTS:Operative and fluoroscopy times were significantly shorter and blood loss was significantly lower in Group 1 than those in Group 2. Complication rates, mean tip-apex indices and recovery of walking ability were similar between groups, whereas independent walking was more common in Group 1 than in Group 2. Until the sixth month, screw cutout occurred in eight (7.8%) and seven (7.3%) patients in Group 1 and Group 2, respectively (p = 0.88). Three-year survival rate was 61.6 ± 9.4 vs 57.3 ± 9.7 % in Group 1 and Group 2, respectively (p = 0.50). CONCLUSION:Proximal femoral nail antirotation technique offers better recovery than dynamic hip screw, whereas both techniques possess the same risk of postoperative complications.
RCT Entities:
AIM: We sought to determine whether intramedullary fixation with proximal femoral nail antirotation produces comparable outcomes to dynamic hip screw in the treatment of unstable trochanteric fractures. MATERIALS AND METHODS:Patients were randomly allocated to receive proximal femoral nail antirotation (Group 1, n = 96, mean age; 77.22 ± 6.82 years) or dynamic hip screw (Group 2, n = 102, mean age; 76.86 ± 6.74 years). Outcome measures were time of operation and fluoroscopy, amount of blood loss and occurrence of surgery-related complications. Tip-apex distance and femoral neck shortening were also evaluated. Patients were evaluated at the sixth month to assess the recovery of walking ability. Survival information was obtained from a civil registry. RESULTS: Operative and fluoroscopy times were significantly shorter and blood loss was significantly lower in Group 1 than those in Group 2. Complication rates, mean tip-apex indices and recovery of walking ability were similar between groups, whereas independent walking was more common in Group 1 than in Group 2. Until the sixth month, screw cutout occurred in eight (7.8%) and seven (7.3%) patients in Group 1 and Group 2, respectively (p = 0.88). Three-year survival rate was 61.6 ± 9.4 vs 57.3 ± 9.7 % in Group 1 and Group 2, respectively (p = 0.50). CONCLUSION: Proximal femoral nail antirotation technique offers better recovery than dynamic hip screw, whereas both techniques possess the same risk of postoperative complications.
Authors: R K J Simmermacher; J Ljungqvist; H Bail; T Hockertz; A J H Vochteloo; U Ochs; Chr v d Werken Journal: Injury Date: 2008-06-25 Impact factor: 2.586
Authors: Sharon R Lewis; Richard Macey; Joseph Lewis; Jamie Stokes; James R Gill; Jonathan A Cook; William Gp Eardley; Martyn J Parker; Xavier L Griffin Journal: Cochrane Database Syst Rev Date: 2022-02-10